Healthcare is people, not logos

The discussions and debates regarding health care on both the local and national levels have been going on for years as people everywhere have tried to come to grips with rapidly rising costs, a huge number of uninsured people and loss of benefits from providers. The volume of the discourse has risen to screaming new levels since the passing of the national Affordable Care Act and the botched launch of the website enrollment in recent weeks. The controversy has given rise to many instant geniuses on both sides with much of the opinion being offered short on fact, insight or applicability to the real world the rest of us inhabit.

What seems to be missing in all this is addressing the underlying question: How does our great nation get health services to those who need it in an affordable, efficient, ethical manner?

Like most, I dodged everything about health care through my mid-20s by being young and invincible, getting by with a few stitches or some ice and aspirin when injuries happened, until I married a health care professional who insisted that I get health insurance as a prelude to “I do.” She knew firsthand the consequences of living without a health care provider in case of emergency and saw the effects everyday at the hospital. I was young and in love so I agreed.

For the past 26 years we have dutifully paid those monthly premiums, which only rise in costs. During those decades we’ve probably had claims of around $5,000, most of which occurred more than 20 years ago. With premiums averaging around $500 per month during that time, I calculate we’ve paid in around $170,000 to our insurers, enough to buy a nice little house, for cash.

We’ve tried to live fairly healthy lifestyles by getting a lot of exercise, eating right and largely shying away from hazardous diets and activities whenever possible, which has allowed us to live without prescription meds, obesity, high blood pressure or any of America’s most common health disorders. Even so, our premiums continue to rise, now exceeding $600 per month with limited coverage for dental, vision, pregnancy and a host of other ailments and injuries, coupled with a $7,500 annual deductible that we pay out of pocket before insurance kicks in. So who needs heath insurance at those prices, right? How else could American families use that $600 per month?

One month ago I found out more than I ever desired about healthcare and local hospitals when a stack of lumber shifted the wrong way and came down on me, shattering my wrist in 12 places. I could tell you that it hurt a lot, but suffice it to say that I headed to Sylva’s emergency room for an assessment of the twisted wreckage and something strong from the pharmacy. I handed them my insurance card, gave them my information, and a wonderful, caring staff did everything possible to make me comfortable while we waited for Dr. Senicki to arrive. Thank goodness he did in short order, and before to long I was headed from the ER to the OR to have four long screws and a steel rod installed on my forearm to stretch my bashed wrist back into place. They called my wife at work to let her know that she could pick up her husband around 5 p.m. at the recovery room, and she could only assume there was a good explanation waiting for her when she arrived.

For the foreseeable future I would be a pain-wracked, one-armed semi-invalid in need of a lot more care than I did just a few hours ago. Ten days later I was back to get an MRI (a very cool digital 3-D video of my wrist from all angles) and a meeting with Dr. Gates, the upper extremities guy, for discussions about the MRI and the upcoming surgery to put this thing back together. With just a basic understanding of anatomy and skeletal structure, the MRI was revealing and confirming in a frightening way.

The breaks were significant and pieces were scattered. I believe the non-medical term he used was “dusted,” which didn’t sound all that rosy to me. We discussed the surgical process, which rang as significantly complex and at least a little scary. I told him that I would like to get a second opinion before setting up the surgery, which he agreed was a prudent next move given this complex situation.

My personal study of American health care was headed deeper and seemed to be only looming larger for me to experience “single-handedly,” so to speak.

My wife recommend I visit Dr. Paul Cutting over at Med-West Haywood whom she had heard speak to her department there and knew that he had done some of his training in Afghanistan, treating trauma and war-related injuries in addition to sports and accidental-type surgery. I made the appointment and saw him two days later. He reviewed the MRI and likened my injury to a wound from an AR-15 bullet through the wrist he had treated while at war. He urged me not to delay much longer in getting the surgery done, regardless of who performed it, for best healing and results, and described in detail how and where the steel plates would be attached to the newly-configured jigsaw puzzle of a wrist I owned. I listened closely to this dedicated professional who convincingly conveyed that he truly had my best interests at heart, and I pictured him parachuting out of a plane with his medical bag to patch up the troops, and I was in the platoon. He checked his schedule and said he could do the surgery tomorrow at 3 p.m. and I automatically replied “Let’s do this.”

On the Friday before Thanksgiving and the day before the arrival of our first holiday guests, I was prepped and wheeled into the OR for the second time in recent days. Again I was struck by the caring, compassionate and dedication of the staff who kept me informed and engaged amidst the flurry of screens, devices, lights and apparatus of haunting description. The anesthesiologist came in and worked his magic while I bid them all good luck and goodnight. After three hours on the slab they closed up the skin and I was off to recovery, again. It now being nearly 7 p.m., the doctor ordered me a night at the hospital for monitoring and pain management, and — not to be outdone by the surgical team — the second floor staff equally impressed me with their efforts to no end as I lay in my electric bed with a giant splinted appendage beside me.

Nurse Mark worked the 7 to 7 shift and let me know he’d be with me all night, which he was, and I could not have asked for better care. Everyone down to the cleaning staff seemed to try extremely hard to care for me, putting the “care” back in health care, far from the rants and yelling on the streets, in the halls of Congress and blanketing the nightly news.

We’re a month since that split-second incident that changed everything and everyday seems to be a little bit better, which makes me optimistic since it will be many months, until I’m close to where I was before. Dr. Cutting, whom I deeply admire and respect, informed me that I will likely have some permanent loss of range of motion and possibly arthritis issues, but both of us remain guardedly optimistic for a useable wrist for the rest of my life. Not having a right hand for the past month has forced me to do just about everything differently and to again understand how easy it is to take convenience for granted. Just for fun, try putting your favored hand firmly at your side unable to be moved and make coffee, get dressed, shave, take a shower, plug in your smartphone, put on your socks, brush your teeth. When you’re comfortable doing that, try washing dishes, make dinner, drive your truck, pick up some groceries and clean the messes off the floor you made trying to do all this. Loss of use of an arm, a leg or an eye or anything else can give a person reason to stop and think about a lot of things — including health care and whether you or anybody else really needs it.

I’ve watched the health care/hospital reshuffle here in WNC for the past 15 years and have been kept informed of the complicated details through the continuing work of this newspaper, who I thank for their in-depth research and reporting. I hope that the latest agreements with Duke Lifepoint in managing the region’s health care lead it to the best that it can be, but after my recent experiences I’m convinced that it is the staff and the teams working together that make our region’s healthcare work, not the logo hanging over the door or on every billing form and communiqué.

I’m more than a little disappointed in our lawmakers in Washington slinging mud and insults at any effort to address national health care issues for political gain rather than working to craft a plan that really works for the people that they supposedly represent. The current debate reminds me not of the Constitution where “all are equal under the law,” but George Orwell’s 1945 novel Animal Farm where “some animals are more equal than others.”

What we need is not jaded, shouting special interests but good people dedicated to providing quality health care to the best of their ability in order to develop a truly workable, unbiased solution. It is my hope that maybe the nation can learn something from the great health care talent and dedication we have here in WNC.